DR. ENRICO A MELSON (NPI# 1770772071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770772071 |
| Entity Type | Individual |
| Full Name | DR. ENRICO A MELSON |
| Credential | MD |
| Practice Address |
17500 Foothill Blvd Suite A-2 Fontana CA 92335-3798 |
| Mailing Address |
200 Oceangate Suite 100 Long Beach CA 90802-4317 |
| Practice Telephone | 9094280170 |
| Practice Fax Number | 9094285145 |
| Mailing Telephone | 5624996191 |
| Mailing Fax Number | 5624996171 |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2010-07-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | G59473 | CA | Allopathic & Osteopathic Physicians |
| Y | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
G59473 | CA | Allopathic & Osteopathic Physicians |
| N | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
G59473 | CA | Allopathic & Osteopathic Physicians |
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
G59473 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | 1720241961 | 01 |
| Street Address |
17500 FOOTHILL BLVD SUITE A-2 |
| City | FONTANA |
| State | CA |
| Zip Code | 92335-3798 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922037738 | Lannie Moy | Family Medicine | 17500 Foothill Blvd, #a-2, Fontana, CA 92335-3736 | 2006-07-02 |
| 1912394255 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 17500 Foothill Blvd, Suite A2, Fontana, CA 92335-3736 | 2015-04-24 |
| 1265860167 | Chidi R. Duru | Nurse Practitioner | 17500 Foothill Blvd, A-2, Fontana, CA 92335-3798 | 2013-10-31 |
| 1922379668 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 17500 Foothill Blvd, #a-2, Fontana, CA 92335-3798 | 2012-01-25 |
| 1750510251 | Jennifer Josephine D'sa | Family Medicine | 17500 Foothill Blvd, #a-2, Fontana, CA 92335-3798 | 2009-07-07 |
| 1487803433 | Laura Y. Jimenez, Dds Prof. Dental Corp | Dentist | 17500 Foothill Blvd, Fontana, CA 92335-3736 | 2008-09-15 |
| 1487786323 | Ricardo Villanueva | Dentist | 17500 Foothill Blvd, Suite C-2, Fontana, CA 92335-3736 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1790312791 | Trevor Nguyen | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd, Building A, Fontana, CA 92335 | 2020-03-27 |
| 1184251365 | Benjamin Chang | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd., Bldg. A, Fontana, CA 92335 | 2020-03-26 |
| 1407487309 | Perla Hernandez | Licensed Vocational Nurse | 14677 Merrill Aver, Fontana, CA 92335 | 2020-01-29 |
| 1013552660 | Valencia Malone | Licensed Vocational Nurse | 14677 Merrill, Fontana, CA 92335 | 2019-11-07 |
| 1831749779 | Daniel Eric Wright | Student in an Organized Health Care Education/Training Program | 14677 Merrell Ave., Fontana, CA 92335 | 2019-09-12 |
| 1962069815 | Melissa Rivera | Licensed Vocational Nurse | 15217 San Bernardino Ave., Fontana, CA 92335 | 2019-05-28 |
| 1275199770 | Jennifer Lynn Malone | Peer Specialist | 14677 Merrall Ave, Fontana, CA 92335 | 2019-05-10 |
| 1770147894 | Noelle Chong | Registered Nurse | 14677 Merill Ave, Fontana, CA 92335 | 2019-04-24 |
| 1992261929 | Destiny Alzate | Counselor | 1467 Merrill Ave, Fontana, CA 92335 | 2019-02-14 |
| Find all providers in zip 92335 | ||||
| Taxonomy Code | 2083P0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Preventive Medicine/Occupational Environmental Medicine |
| A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750911665 | Healthstat Wellness Sutter County | Preventive Medicine | 1215 Plumas St Ste 1300a, Yuba City, CA 95991-3400 | 2020-01-20 |
| 1194373530 | Healthstat Wellness County of Santa Barbara Headquarters | Preventive Medicine | 427 Camino Del Remedio Bldg G, Santa Barbara, CA 93110-1310 | 2019-08-29 |
| 1023678661 | Linda K Watanabe | Preventive Medicine | 700 Bay Rd. #2803, Redwood City, CA 94063 | 2019-06-17 |
| 1750872255 | Universal Occupational Medicine PC | Preventive Medicine | 8303 Brimhall Rd Bldg 1500, Bakersfield, CA 93312-2243 | 2018-05-21 |
| 1831694272 | Healthstat Wellness County Sb Headquarters | Preventive Medicine | 2500 Broadway Ste 400, Santa Monica, CA 90404-3176 | 2018-03-28 |
| 1326548363 | Paul Manchester | Preventive Medicine | 11159 Corte Pleno Verano, San Diego, CA 92130-2688 | 2018-02-16 |
| 1295240679 | Robert A Brooks | Preventive Medicine | 149 South Barrington Ave, #346, Los Angeles, CA 90049 | 2017-12-07 |
| 1285145383 | Brett V. Curtis M.d. & Associates, A Professional Corporation | Preventive Medicine | 7428 Redwood Blvd Ste 100, Novato, CA 94945-2418 | 2017-10-16 |
| 1104355783 | Susan Bradshaw | Preventive Medicine | 6320 W Howard Drollinger Way Ste 203, Los Angeles, CA 90045-3627 | 2017-06-07 |
| 1386097806 | Healthstat Wellness Bac Madera | Preventive Medicine | 15341 Road 28 1/2, Madera, CA 93638-2325 | 2016-07-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. ENRICO A MELSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.